Health Screenings and Immunizations Flashcards
What is primary prevention ?
basic actions we can all take to stay healthy
- focus is to maintain/improve general individuals/family/ or community health
- lowest cost interventions
- like health education, immunizations, exercise
- health promotion and specific protection
What is secondary prevention ?
focuses on screenings
- goal is to identify individuals in early, detectable stages of disease
- also includes questionnaires where you ask if you feel safe at home or with your current partner
- applied to specific individuals/populations with disease
- early diagnosis, prompt treatment, disability limitation
What is tertiary prevention ?
actions we take to minimize the effects of a disease we already have and are experiencing
- objective is to return the patients to engaged places in society and to maximize remaining capacity
- when disease is permanent or irreversible (HIV infection, stroke)
- recovery and rehabilitation
What are the roles of public health ?
- decrease preventable death rates
- increase life expectancy and quality of life
- ensure health equity through public programming offering (vaccines, screenings, and education)
- provide health surveillance and protection (water quality monitoring, inspection of food service and supply)
Why are health screenings important ?
helps us identify chronic conditions and risk factors before the condition becomes costly both in financial terms and in quality of life
What is an upstream thinking of health inequalities ?
thinking about why something is happening
- like social inequalities like race, gender, sexual orientation
What is downstream thinking of health inequalities ?
were we are as healthcare workers
- risk behaviors, disease and injuries
What are some advantages of screenings ?
- usually simple and inexpensive
- opportunity to provide education to underserved populations
- individual or group screenings
What are some disadvantages of screenings ?
- anxiety over false positive
- cost
- imperfection/margin or error (can get borderline answers or false results)
- follow up is not guaranteed
What is an interobserver reliability ?
same result when 2 individuals perform the test
What is an intraobserver reliability ?
same person able to reproduce the results several times
What does the validity of a screening mean ?
reflects the accuracy or truthfulness of the test or instrument itself
What does the sensitivity of a screening mean ?
the proportion of people who correctively test positive when screened
- how likely the test is to detect a condition when it’s actually present in the patient
- good sensitivity= false negative will decrease
What does the specificity of a screening mean ?
measure the test’s ability to recognize negative reactions or non-diseased individuals
- how well the test identifies the absence of the disease being tested
- poor specificity= false positive will increase
What happens to the specificity if you increase the sensitivity ?
as you increase the sensitivity the specificity decreases
What is the risk factors with Breast Cancer ?
- nulliparous (never given birth) women at highest risk because they have never had that protective factor that happens with hormonal changes in breastfeeding or pregnancy
- risk increases with age
- women who had their first child before age 30 at the lowest risk
What are the age ranges/life stages when breast cancer screenings are done ?
- 20’s-30s: clinical breast exams every 3 years
- 40-44: have the choice to start annual screenings with mammograms if you wish
- 45-54: get mammogram every year
- 55 and older: can have mammogram every 2 years or continue to do annually (if provider agrees)
- Woman at high risk: MRI exams annually
- screenings should continue as long as you are in good health and expected to live at least 10 more years
Why don’t we perform cervical exams in woman until age 21 ?
in adolescence it’s normal for cervical tissue to change or have abnormal cells
What are the age ranges/life stages when cervical exams (pap smears) are done ?
- 21-29: pap test every 3 years with HPV testing if pap is abnormal
- 30-65: pap test + HPV test every 5 years or just pap test every 3 years
- 65+: no testing recommended if regular cervical exams in the past 10 years were normal
How are pap tests done ?
swab inserted inside the cervix, and they scrape the surface level cervix cells and get that tested to see if cells are abnormal
What are some exceptions to pap tests ?
- women with a history of cervical cancer should be tested at least 20 years after diagnosis regardless of age
- women who have had a total hysterectomy should not be tested
- women who are at high risk due to DES exposure, immunocompromised, or have HIV infection should discuss be screening schedules with provider
What are the testing recommendations for colorectal cancer screenings ?
- 45-75: general population should start to get tested for this cancer every 10 years (can start at 50 depending on the agency)
- for adults with family history or are at high risk should start at an earlier age then 45
- 76-85: selective screening (discuss with provider)
- stool testing done every 1-3 years
What are the testing recommendations for colonoscopies ?
begins at age 50 and done every 10 years
Is prostate cancer deadly ?
most likely to die with prostate cancer then to die from it
How as prostate exams done ?
invasive procedure where they insert the finger and they will palpate the prostate to feel for any adnormalities
What are the testing recommendations for prostate cancer ?
- 55-69: men at this age should discuss this decision with their healthcare provider over the benefits or harms
- 70+: against screening at this age
What are the testing recommendations for cholesterol ?
- men at 35+
- women at 45+
- lipoproteins profile and blood pressure screenings every 5 years
What are your levels of HDL-C (healthy fats) supposed to be ?
> 40
What are your levels of TC supposed to be ?
<200
(>200 indicates need for lifestyle modifications)
What are your levels of triglycerides supposed to be ?
<150
What are the testing recommendations for hypertension ?
- periodic testing for all individuals 18+
- get screen everytime you are at a healthcare facility
- at least every 2 years, or annually if previously elevated
What are the testing recommendations for obesity ?
- children, adolescents & adults should be screened for BMI at each health provider visit
What are the BMI levels ?
- underweight: <18.5
- normal: 18.5-24.9
- overweight: 25-29.9
- obese: >30
What is type 1 diabetes ?
born with it or it naturally develops and not because of lifestyle choices
- pancreas not producing insulin
- acute onset usually in childhood/adolescense
What is type 2 diabetes ?
happens because of lifestyle choices
- insulin resistance
When do you screen for type 2 diabetes ?
in adults with comorbidities including hypertension and hyperlipidemia
What are the testing recommendations for diabetes ?
- with no other risk factors, start at age 45 and be done at least every 3 years
When are newborn screenings done ?
state law says every newborn has to have these screenings
- ideally before you leave the hospital
What are the 3 screenings done on newborns ?
- Genetic screenings: blood drawn where you prick the baby’s heel
- Pulse oximetry screen: for critical congenital heart defects (CCHDs)
- hearing screen for hearing loss will be completed
What is active immunity ?
all or part of disease-causing microorganisms or product is injected to make immune system react defensively
- provides lost lasting protection because your immune system does the work
What is passive immunity ?
injecting blood or blood products into a vulnerable person from an actively immune person or animal
- short term immunity (1-6 weeks)
- occurs in newborns when antibodies are passed through placenta or in breast milk
What is the role of the nurse with immunizations ?
- patient education: immunizations across the lifespan
- awareness of recommendation updates
- documentation of all immunizations
- motivate patients to immunize children
- advocate for all infants to receive comprehensive healthcare including immunizations
Is there is a link with thimerosal and autism ?
some people believe that the increased number of recommended immunizations in the first 3 years of life may be associated with increase in autism prevalence
- not true at all and been disproved multiple times
